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Search Results: 1 - 10 of 338382 matches for " Pablo; León B "
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Ventilación de alta frecuencia oscilatoria en pacientes pediátricos High-frequency oscillatory ventilation in pediatric patients
Alejandro Donoso F,Pablo Cruces R,José León B,Milena Ramírez A
Revista Chilena de Enfermedades Respiratorias , 2006,
Abstract: Introducción: La ventilación de alta frecuencia oscilatoria (VAFO) es una modalidad que emplea peque os volúmenes corrientes, habitualmente menores que el espacio muerto anatómico, con rápidas frecuencias respiratorias (> 1 Hz). Esta opción ha sido cada vez más frecuente de disponer en nuestro país en los últimos a os. Objetivos: Revisar la experiencia clínica con el uso de VAFO en nuestra UCI y describir las características de los pacientes, estrategia de VAFO empleada y pronóstico. Pacientes: Un estudio prospectivo, no controlado, de series de casos incluyó pacientes menores de 16 a os, con Síndrome de Distress Respiratorio Agudo (SDRA), frente a fracaso de Ventilación Mecánica Convencional (VMC). Se compararon dos períodos dentro del estudio (1999-2001 y 2002-2004). Resultados: 51 episodios de empleo de VAFO, en 49 pacientes cuyo diagnóstico fue SDRA de causa pulmonar en el 80%. La duración de la VMC previo a la VAFO fue de 47 horas. El índice de oxigenación al iniciarse la VAFO fue 24. La presión media de vía aérea fue fijada en 9 cm H2O sobre el valor en VMC. Se logró una significativa mejoría en la oxigenación y en la ventilación. La duración media de la VAFO fue de 102 horas. El efecto adverso más frecuente fue la hipotensión transitoria (25%). En el segundo período analizado hubo una disminución de las complicaciones hemodinámicas (p < 0,05), como también un incremento en la duración de la VAFO. Un 33% de los pacientes fallecieron, un 22% por causa pulmonar. Conclusión: La VAFO es una terapia eficaz de soporte ventilatorio ante fracaso de la VMC Introduction: High-frequency oscillatory ventilation (HFOV) uses small tidal volumes, often smaller than the anatomic dead space, with high respiratory rates (> 1 Hz). This therapeutic option has become more popular in our country in the last years. Study objectives: To review the clinical experience with HFOV in our Pediatric Intensive Care Unit and to describe the patient's characteristics, HFOV strategies and outcome. Patients: A prospective study included patients less than 16 years old with Acute Respiratory Distress Syndrome (ARDS) refractary to conventional mechanical ventilation (CMV). We compare two periods (1999-2001 and 2002-2004). Measurements and results: Forty-nine patients underwent onto 51 episodes of HFO ventilation, 80% presented with primary ARDS. Previous conventional ventilation was 47 hours long. The median value of the oxygenation index (OI) at the beginning of HFOV was 24. Mean airway pressure was initially set at 9 cmH2O above the value in conventional ventilation. All the patien
Caracterización de la ventilación mecánica no invasiva pediátrica hospitalaria
Valenzuela V,Jorge; Donoso F,Alejandro; León B,José; Díaz R,Franco; Cruces R,Pablo;
Revista chilena de pediatría , 2006, DOI: 10.4067/S0370-41062006000600003
Abstract: background: non-invasive mechanical ventilation (nimv) has been established in the last decade in many pediatric icus worldwide. however, several questions are still present about the real use of this therapy in our country. objective: to describe the use of niv in chile in 2005. method: a survey was sent by internet to all 43 chilean picu, in order to record some aspects like epidemiology, cause of hospitalization, human and material resources, technical parameters and complications regarding every patient ventilated with nimv during 2005. collected data was analyzed considering the overall sample and also separated by geographical regions (13 regions including the metropolitan) and administrative issue (public or private centers). results: 21 units answered the survey (49%), mostly (59%) from public hospitals in the metropolitan region. 4 centers did not use niv in that period, all of them from provinces. this therapy was never instituted outside the icu or high dependency unit (hdu). 68% of the units had this therapy since at least 2 years ago. 71% of the units provided nimv up to 30 patients and 3 units ventilated between 100 and 400 patients in 2005. 71% answered that the average duration of niv was 2-4 days. the most frequent diagnoses were asthma and pneumonia. the failure rate varied from < 1% to 50%. 55% of the units did not have defined criteria of institution or withdrawal of this ventilatory support and, also, 70% did not have a written guideline. conclusion: we had a low response rate to the survey. at least 10% of all of the picus do not provide niv in chile. we found remarkable diversities among the different units regarding the number of treated patients, criteria of institution and withdrawal of nimv, failure rate and absence of guidelines. the information obtained in this survey should be known and analyzed by health team members in order to ensure a more sensible and rigorous use of the nimv
DIAGNóSTICO Y TRATAMIENTO DE LA DEFICIENCIA DE VITAMINA D
Miranda C,Daisy; Leiva B,Laura; León S,José Pablo; de la Maza C,Ma Pía;
Revista chilena de nutrición , 2009, DOI: 10.4067/S0717-75182009000300009
Abstract: nutritional status of vitamin d has regained importance in the last few years because its deficiency is highly prevalent, and because, apart from its well known effects on bone metabolism, this vitamin participates in cellular proliferation and differentiation and muscle strength and balance, among other effects. the active molecule is 1,25(oh)2d, but serum concentration of total 25 oh vitamin d (i.e. including ergocalciferol or vitamin d2 plus chole calciferol or vitamin d3) is the preferred indicator of vitamin d status. recent evidences suggest the need to increase dietary recommendations in adults up to 1,000 iu/day. however, in deficiency states it is often necessary to supplement with pharmaceutical preparations, which contain higher doses of this vitamin since the amounts previously employed were not able to return levels to normal. in the present article we present the entire list of vitamin d preparations commercially available in chile. the difficulty of choosing the most adequate product for an individual patient becomes clear, because there are only few formulations containing more than 800iu and, in addition they are usually combined with calcium, biphosphonates or multiple minerals and other vitamins.
Cateterización de la vena subclavia en pacientes pediátricos menores de 10 kg de peso
Díaz R,Franco; Donoso F,Alejandro; Camacho A,Jorge; Cruces R,Pablo; León B,José;
Revista chilena de pediatría , 2006, DOI: 10.4067/S0370-41062006000500004
Abstract: central venous access are often required in pediatric intensive care units for hemodynamic monitorization and treatment. the subclavian vein catheterization is unfrequently used in critically ill children. objective: to demonstrate that subclavian vein catheterization performed by pediatric staff is a safe and successful access in children with body weight less than 10 kg. method: prospective and observational study that lasts 34 months and includes children with body weight less than 10 kg. a subclavian central venous access was attempted by infraclavicular approach with seldinger technique. the demographic and anthropometric characteristics of the patients and their relevant clinical conditions were registered. the technical variables of the procedure (insertion side, number of attempts) and related complications were listed. group analysis was made according to weight (< 5 kg or > 5 kg). results: 73 catheter insertions were performed in 51 patients; 59% male with age between 8 days and 18 months, weight between 2,3-9,6 kg (median 5 kg). 62% were placed in the right side. 78% cases required mechanical ventilation. 70 out of 73 attempts (96%) were successful (64% first attempt), 97% belonging to the group with weight < 5 kg and 95% to the ones with body weight > 5 kg. 9 (12%) complications occurred. there were no differences between both groups in terms of success and procedure related complications. conclusions: percutaneous subclavian vein catheterization is safe in children with body weight less than 10 kg and it presents low risk of complications. this procedure must be considered as an alternative in critically ill children
Ventilación de alta frecuencia oscilatoria en pacientes pediátricos
Donoso F,Alejandro; Cruces R,Pablo; León B,José; Ramírez A,Milena; Camacho A,Jorge;
Revista chilena de enfermedades respiratorias , 2006, DOI: 10.4067/S0717-73482006000100004
Abstract: introduction: high-frequency oscillatory ventilation (hfov) uses small tidal volumes, often smaller than the anatomic dead space, with high respiratory rates (> 1 hz). this therapeutic option has become more popular in our country in the last years. study objectives: to review the clinical experience with hfov in our pediatric intensive care unit and to describe the patient's characteristics, hfov strategies and outcome. patients: a prospective study included patients less than 16 years old with acute respiratory distress syndrome (ards) refractary to conventional mechanical ventilation (cmv). we compare two periods (1999-2001 and 2002-2004). measurements and results: forty-nine patients underwent onto 51 episodes of hfo ventilation, 80% presented with primary ards. previous conventional ventilation was 47 hours long. the median value of the oxygenation index (oi) at the beginning of hfov was 24. mean airway pressure was initially set at 9 cmh2o above the value in conventional ventilation. all the patients presented a decrease of their oi and ventilation was improved during the first 48 hours of therapy. median duration on hfov was 102 hours. the most frequent side effect was transient hypotension (25%). in the second period we observed a decrease in hemodynamic complications and also an increase in hfo duration. the mortality rate was 33% (22% due to pulmonary cause). conclusion: hfov is an effective therapy for pediatric respiratory failure refractory to conventional mechanical ventilation
DIAGNóSTICO Y TRATAMIENTO DE LA DEFICIENCIA DE VITAMINA D DIAGNOSIS AND TREATMENT OF VITAMIN D DEFICIENCY
Daisy Miranda C,Laura Leiva B,José Pablo León S,Ma Pía de la Maza C
Revista Chilena de Nutricíon , 2009,
Abstract: El estado nutrícional de vitamina D ha cobrado importancia en los últimos a os debido a que su deficiencia es altamente prevalente, y además por sus conocidos efectos en el metabolismo óseo, participa en la diferenciación y proliferación celular, función muscular y equilibrio, entre otros. La molécula activa es la 1,25(OH)2D, pero se recomienda medir niveles séricos de 25 OH vitamina D total (es decir la suma de ergocalciferol o vitamina D2 y colecalciferol o vitamina D3), como reflejo del status de vitamina D. La evidencia actual sugiere la necesidad de elevar las recomendaciones para la ingesta dietaria en adultos, hasta cifras cercanas a 1.000 Ul/día. Sin embargo en casos de deficiencia puede ser necesario utilizar suplementos farmacéuticos conteniendo dosis superiores de esta vitamina, por cuanto aquellas utilizadas en el pasado no lograban corregir el déficit. En este artículo se presenta un listado de los preparados comerciales que contienen vitamina D disponibles en Chile. Al analizarlo se pone de mamfiesto la dificultad que representa elegir el preparado más adecuado para corregir la deficiencia en un paciente individual, debido a que son pocas las preparaciones que contienen más de 800 UI, además de que habitualmente se encuentra en asociación con calcio, bifosfonatos o múltiples otros minerales y vitaminas. Nutritional status of vitamin D has regained importance in the last few years because its deficiency is highly prevalent, and because, apart from its well known effects on bone metabolism, this vitamin participates in cellular proliferation and differentiation and muscle strength and balance, among other effects. The active molecule is 1,25(OH)2D, but serum concentration of total 25 OH vitamin D (i.e. including ergocalciferol or vitamin D2 plus chole calciferol or vitamin D3) is the preferred indicator of vitamin D status. Recent evidences suggest the need to increase dietary recommendations in adults up to 1,000 IU/day. However, in deficiency states it is often necessary to supplement with pharmaceutical preparations, which contain higher doses of this vitamin since the amounts previously employed were not able to return levels to normal. In the present article we present the entire list of vitamin D preparations commercially available in Chile. The difficulty of choosing the most adequate product for an individual patient becomes clear, because there are only few formulations containing more than 800IU and, in addition they are usually combined with calcium, biphosphonates or multiple minerals and other vitamins.
Los estudios históricos y las relaciones hispano-norteamericanas durante la II Guerra Mundial y la Guerra Fría.
Pablo León Aguinaga
Circunstancia , 2012,
Abstract: Este artículo rastrea la evolución de los estudios históricos sobre las relaciones entre Espa a y Estados Unidos desde inicio de la II Guerra Mundial (1939) hasta el cierre de la Guerra Fría (1991). Los estudios sobre el tema han reflejado las peculiaridades de unas relaciones determinadas por la evolución de las relaciones transatlánticas a partir del desenlace del primer conflicto y el devenir del segundo, que convirtieron a los Estados Unidos de América en referente y socio ineludible del conjunto de Europa Occidental en materia diplomática, militar, económica y cultural. Hasta los a os noventa del siglo pasado, los estudios de corte diplomático-estratégico dominaron cuantitativamente la producción historiográfica, en demasiados casos obra de historiadores no profesionales o científicos sociales con poca atención al método histórico. Afortunadamente, en los últimos a os el creciente interés por el papel de las transferencias culturales y económicas en las relaciones internacionales de la historiografía espa ola ha alumbrado un considerable número de novedosos estudios y perspectivas, que junto a un grupo de trabajos debidamente documentados y concebidos sobre las relaciones diplomáticas y estratégicas, ofrecen una visión cada vez más contrastada de la auténtica naturaleza y múltiples consecuencias del vínculo bilateral a lo largo de este periodo.
EMBARAZO ECTOPICO BILATERAL SIMULTANEO
Trujillo N,Carlos; Salazar G,Pedro; Moreno L,Luis; Manríquez G,Valentín; Venegas F,Patricio; Quinteros G,Pablo; León B,Manuel;
Revista chilena de obstetricia y ginecología , 2002, DOI: 10.4067/S0717-75262002000100011
Abstract: we present a clinical case of a 29 year-old patient, which was subjected to an exploratory laparotomy with the diagnosis of a complicated right tubal pregnancy. at operation is proven this diagnosis, and the presence of a left tubal pregnancy was found
Colonización por Staphylococcus aureus resistente a meticilina en las manos de individuos de la comunidad
Báez Benavides,Pablo Felipe; Zapata Tamayo,Mario Augusto; Ramírez Pérez,Auxilio; Rúa Giraldo,Alvaro León; Jiménez Quiceno,Judy Natalia;
Iatreia , 2010,
Abstract: hand colonization by methicillin-resistant staphylococcus aureus (mrsa) in the community community-associated methicillin-resistant staphylococcus aureus infections (ca-mrsa) have been reported with increasing frequency during the past decade. colonization plays an important role in the epidemiology of such infections. however, colonization studies have focused mostly on hospital settings and only a few have been carried out in communities. this was a study of the frequency of hand colonization by s. aureus in general and by ca-mrsa, by means of phenotypical and molecular methods, in 800 adults from the community who had no relationship with the health area. staphylococcus aureus colonization was found in 65 individuals (8.1%) and mrsa was present in 5 (0.63%). the 5 mrsa strains were found to have mecchromosomic cassettes (sccmec) of either type iv or v, typical of ca-mrsa. our study provides evidence of ca-mrsa colonization in the hands of individuals from the community. this constitutes an important risk factor, not only by its association with subsequent infections, but also for the risk of dissemination of this microorganism to the general population.
Book review: VV.AA. La CT o La Cultura de la Transición. Crítica a 35 a os de cultura espa ola, Barcelona, Debolsillo, 2012. La Ceté, un cambio de gafas para observar 30 a os de democracia
Pablo Sánchez León
Teknokultura : Revista de Cultura Digital y Movimientos Sociales , 2012,
Abstract: Book review: VV.AA. La CT o La Cultura de la Transición. Crítica a 35 a os de cultura espa ola, Barcelona, Debolsillo, 2012. Rese a del libro: VV.AA. La CT o La Cultura de la Transición. Crítica a 35 a os de cultura espa ola, Barcelona, Debolsillo, 2012.
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